Histopathological Changes in the Liver, Heart and Kidneys Following Malayan Pit Viper ( Calloselasma rhodostoma ) Envenoming and the Neutralising Effects of Hemato Polyvalent Snake Antivenom

• Published in: Toxins 2022-08, Vol.14 (9), p.601
• Main Authors: Khimmaktong, Wipapan, Nuanyaem, Nazmi, Lorthong, Nissara, Hodgson, Wayne C, Chaisakul, Janeyuth
• Format: Article
• Language: English
• Subjects: Agkistrodon; Amyloidosis; Animal models; Animals; Antivenins; Antivenins - pharmacology; Antivenins - therapeutic use; Antivenom; Bites and stings; Blood pressure; Calloselasma rhodostoma; cardiac; Complications and side effects; Congestive heart failure; Cytoplasm; Disturbances; Heart; Heart rate; Hematuria; Hemorrhage; hepatic; Hepatotoxicity; Inflammation; Intravenous administration; Kidney; Kidneys; Liver; Malayan pit viper; Microscopy; Morbidity; Morphology; Mortality; Patient outcomes; Physiological aspects; Rats; renal; Renal Insufficiency - drug therapy; snake; Snake Bites - drug therapy; Snakes; Veins & arteries; Venom; Venoms; Viper Venoms
• ISSN: 2072-6651; 2072-6651
• DOI: 10.3390/toxins14090601

(Malayan pit viper) is a medically important snake species that is widely distributed across Southeast Asia. Systemic coagulopathy causing severe haemorrhage and local tissue injury is commonly observed following envenoming. However, nephrotoxicity and congestive heart failure were previously reported in a patient who had a long length of hospital stay. In this study, we determined the effect of envenoming on cardiovascular disturbances and the associated morphological changes in the liver, heart and kidneys using animal models. We also evaluated the efficacy of Hemato polyvalent antivenom (HPAV; Queen Saovabha Memorial Institute (QSMI) of the Thai Red Cross Society, Thailand) in neutralising the histopathological effects of venom. The intravenous (i.v.) administration of venom (1000 µg/kg) caused a rapid decrease in mean arterial pressure (MAP) followed by complete cardiac collapse in anaesthetized rats. Moreover, the intraperitoneal (i.p.) administration of venom (11.1 mg/kg; 3 × LD ) for 24 h caused cellular lesions in the liver and heart tissues. venom also induced nephrotoxicity, as indicated by the presence of tubular injury, interstitial vascular congestion and inflammatory infiltration in the whole area of the kidney. The administration of HPAV, at manufacturer-recommended doses, 15 min prior to or after the addition of venom reduced the extent of the morphological changes in the liver, heart and kidneys. This study found that experimental envenoming induced cardiovascular disturbances, hepatotoxicity and nephrotoxicity. We also highlighted the potential broad utility of HPAV to neutralise the histopathological effects of venom. The early delivery of antivenom appears capable of preventing envenoming outcomes.